NPI | 1700443744 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLY MARIE WITKOWIAK Co Owner 414-899-0793 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2019-05-24 |
Last Update Date | 2019-05-24 |